In her Facebook response (reproduced here) to President Obama, citizen Palin cites chapter and verse on why people should be concerned that Obamacare will include independent panels that will make life-and-death decisions. These panels operate at the personal level and at the policy level. At the personal level, quoting Palin:

Section 1233 authorizes advanced care planning consultations for senior citizens on Medicare every five years, and more often “if there is a significant change in the health condition of the individual … or upon admission to a skilled nursing facility, a long-term care facility… or a hospice program.” During those consultations, practitioners must explain “the continuum of end-of-life services and supports available, including palliative care and hospice,” and the government benefits available to pay for such services.

And at the policy level, again quoting Palin:

My original comments concerned statements made by Dr. Ezekiel Emanuel, a health policy advisor to President Obama and the brother of the President’s chief of staff. Dr. Emanuel has written that some medical services should not be guaranteed to those “who are irreversibly prevented from being or becoming participating citizens….An obvious example is not guaranteeing health services to patients with dementia.” [10] Dr. Emanuel has also advocated basing medical decisions on a system which “produces a priority curve on which individuals aged between roughly 15 and 40 years get the most chance, whereas the youngest and oldest people get chances that are attenuated.” [11]

President Obama can try to gloss over the effects of government authorized end-of-life consultations, but the views of one of his top health care advisors are clear enough.

Of course, President Obama didn’t help his cause when he pondered whether or not his grandmother should have received a hip replacement. Kausfiles has the fatal transcript:

Well, I think that there is going to have to be a conversation that is guided by doctors, scientists, ethicists. And then there is going to have to be a very difficult democratic conversation that takes place. 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. It’s not determinative, but I think has to be able to give you some guidance. And that’s part of what I suspect you’ll see emerging out of the various health care conversations that are taking place on the Hill right now.

Some Democrats are twisting Palin’s word to suggest she claimed the bill promoted euthanasia. Howard Dean is one:

On CNN Sunday, former DNC Chairman and Vermont Governor Howard Dean dismissed Palin’s comments. “About euthanasia, they’re just totally erroneous. She just made that up,” he said. “Just like the ‘Bridge to Nowhere’ that she supposedly didn’t support.

“There’s nothing like euthanasia in the bill. I practiced medicine for a long time, and of course you have to have end of life discussions – the patients want that,” Dean said. “There’s nothing… euthanasia’s not in this bill.”

But Palin did not talk about euthanasia; she was talking about the denial of life-saving or life-extending care based on demographic and cost considerations. Replacing expensive life-saving care with cheap palliative care is not euthanasia, although it is on the same slippery slope.