It's not difficult to pick out the shrillest, nastiest, most partisan moment of the shrill, nasty, partisan health care reform war of 2009-2010: death panels. Critics seized the reform bill's early provision to cover end-of-life counseling as evidence that President Obama wanted to establish "death panels" to, as Senator Chuck Grassley put it, "pull the plug on Grandma." Eventually the claim was discredited and died out--despite Sarah Palin's best efforts--in early 2010. But good news: the death panel meme is back! Many conservatives expressed outrage when a new provision, implemented Jan. 1, offered Medicare coverage for end-of-life counseling as part of an annual check-up. On Tuesday, the White House quietly removed this provision. Here's what happened, why, and a brief sample of the death panel war's latest skirmish.

  • 'Back By Administrative Fiat'  The Washington Post's Charles Krauthammer wrote on New Years Eve that the counseling that could have been "a possible first slippery step on the road to state-mandated late-life" was "back--by administrative fiat." He fumed, "so much for the Democrats' transparency--and for their repeated claim that the more people learn what is in the health-care law, the more they will like it. Turns out ignorance is the Democrats' best hope."
  • Doctors Want Grandma to Avoid Life-Extending Treatments   Guest-hosting on Fox News, Tucker Carlson said, "Remember those infamous death panels? ... According to The New York Times, this new regulation may provide Americans, quote, 'advanced directives to forego aggressive life-sustaining treatment.' In other words, the government will now pay doctors to counsel patients to opt out of medical treatment that might prolong their lives." Via Media Matters.
  • A Necessary Move  The Chicago Sun-Times praised the decision to reinsert end-of-life counseling. "End-of-life counseling is simply a way to educate patients about their options, so they can take the next step of drafting a 'living will' and appointing a health-care proxy who can make treatment decisions on their behalf when they are no longer able," they wrote. "People who make their wishes known in advance are more likely to receive the kind of end-of-life care they want than people who don’t."
  • Why Obama Dropped Counseling Provision  The New York Times' Robert Pear explains the "abrupt shift" by pointing out that "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." Still, the move has "upset some officials at the Department of Health and Human Services, who said the administration ought to promote discussions of such care."
  • We Still Need To Solve This Problem  The Baltimore Sun's Alexander Brooke laments the "moral travesty" that can come when people have not done end-of-life planning. But both Congress and the White House have avoided the problem. "Thinkers and moralists since Socrates and Seneca have encouraged humans to learn the art of dying: to prepare to live their last days on their own terms. Encumbered by medical advances, financial drives and litigious fears, the lessons of the sages remain more elusive than ever, as family members of my very kind neighbor sadly realized."