It is very difficult to imagine the country making those decisions just through the normal political channels. And that's part of why you have to have some independent group that can give you guidance.
—President Barack Obama in a New York Times interview on how costly medical decisions should be made.
The people behind the long table do not know what they've become. The drug of power has been sugared over in their mouths with a flavoring of righteousness. Someone has to make these decisions, they tell their friends at dinner parties. It's all very difficult for us. But you can see it in their eyes: It isn't really difficult at all. It feels good to them to be the ones who decide.
"Well, we have your doctor's recommendation," says the chairwoman in a friendly tone. She peers over the top of her glasses as she pages through your file.
You have to clear your throat before you can answer. "He says the operation is my only chance."
"But not really very much of a chance, is it?" she says sympathetically. Over time, she's become expert at sounding sympathetic.
"Seventy percent!" you object.
"Seventy percent chance of survival for five years—five years at the outside—and even that only amounts to about 18 months in QALYs: quality-adjusted life years."
"But without this procedure, I'll be dead before Christmas."
You try to keep the anger out of your voice. The last thing you want to do is offend them. But the politicians promised you—they promised everyone—there would never be panels like this. They made fun of anyone who said there would. "What do they think we're going to do? Pull the plug on grandma?" they chuckled. The media ran news stories calling all rumors of such things "false" or "misleading." But of course by then the media had become apologists for the state rather than watchdogs for the people. ...
Read the rest here. Frankly, I suspect that those who serve on these "Death Panels" will find their own imperious lifespans cut unexpectedly short by those (or their loved ones) whose lives the state decides aren't "worth the cost". Especially when it comes to light (as it surely will) that there are two de facto sets of rules, one for the masses, and another, more kindly set for the privileged and politically connected. No doubt the rules will be facially the same for everyone, but how they're applied will differ depending on which class of person you are.