Republicans voted for "death panels" before they were against them

Republicans like Sen. Grassley used to know the difference between end-of-life counseling and euthanasia

Published August 14, 2009 8:25PM (EDT)

The Great Death Panel Panic of Aught-Nine now seems to be wrapping up. Since Republicans like Sen. Charles Grassley, R-Iowa, threw their lot in with the panicked conservative grassroots, they've taken a big step towards making sure that the relevant section of the healthcare reform legislation -- the part that deals with insurance coverage for end-of-life counseling -- won't be in the final bill.

Unfortunately, it’s not possible for a piece of legislation to do any deathbed reflection. But I like to think that if the end-of-life measure could have called us into its hospital room and had a hushed bedside conversation with the American people, well, it might not have had the nicest things to say about Grassley.

There are plenty of reasons for cutting Grassley out of the will, so to speak. For one thing, the Iowa Republican is the ranking member of the Finance Committee, and a key healthcare negotiator. He very clearly helped sustain the hyperbolic fear about the “death panels,” saying, “You have every right to fear . . . We should not have a government program that determines if you're going to pull the plug on grandma.” Then, after he helped to ensure that the Finance Committee would not consider the provisions while working out its version of the bill, he announced that the committee had done so “because of the way they could be misinterpreted and implemented incorrectly.”

Then, Thursday night, Time’s Amy Sullivan reported that Grassley actually voted for a version of this same idea, back in 2003. On Friday, Greg Sargent added the names of several more Republicans. Reps. John Boehner, Thaddeus McCotter and John Mica -- each of whom has warned about some kind of government euthanasia or “death counselors” -- all voted for the idea six years ago.

To be fair, what these Republicans supported isn’t exactly the same as what they're opposing now, in part because it only applied to the terminally ill. And there is also the question of whether they even knew that the provision was in the 2003 bill -- with Republicans in charge at the time, there would have been no one to lead a fight against it, and they had to support the president at the time. (That's why these kinds of broad pieces of legislation often get used for campaign ads; there's so much in them that candidates can typically find one piece of a much larger bill with which they can tar their opponents.)

In a statement, Michael Steel, a spokesman for Boehner, called the comparison between the two votes "idiotic," saying:

Anyone who understands this issue would find this comparison idiotic. Hospice care is, by definition, for people who are already close to death. The Democrats’ new government takeover of health care legislation would offer this counseling to every senior on Medicare.

For the record, the provision being debated isn't just about hospice care. It would also mean coverage for counseling on things like living wills, which are useful not just for the terminally ill but for people who suddenly and without warning find themselves incapacitated.

Still, you can hardly blame any of these guys for the original vote. After all, as the Washington Post noted today, there’s pretty good evidence showing that, not only do “death counselors” not perform grisly murder, they actually improve the quality of the last stage of a patient’s life. Patients who meet with end-of-life counselors are less likely to spend their last week on a ventilator or in intensive care. The costs for that final week are also, on average, 36 percent lower. 

It’s almost too obvious to need repeating, but healthcare legislation has direct consequences involving people suffering and dying. At one point, Chuck Grassley seemed to know that.

By Gabriel Winant

Gabriel Winant is a graduate student in American history at Yale.

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