That whole issue of “death panels” is back:

On Sunday, Robert Pear reported in the New York Times that Medicare will now pay for voluntary end-of-life counseling as part of seniors’ annual physicals. A similar provision was originally included in ObamaCare, but Democrats stripped it out amid the death panel furor. Now Medicare will enact the same policy through regulation.

We hadn’t heard about this development until Mr. Pear’s story, but evidently Medicare tried to prevent the change from becoming public knowledge. The provision is buried in thousands of Federal Register pages setting Medicare’s hospital and physician price controls for 2011 and concludes that such consultations count as a form of preventative care.

The office of Oregon Democrat Earl Blumenauer, the author of the original rider who then lobbied Medicare to cover the service, sent an email to supporters cheering this “victory” but asked that they not tell anyone for fear of perpetuating “the ‘death panel’ myth.” The email added that “Thus far, it seems that no press or blogs have discovered it, but we will be keeping a close watch.”

Anytime proponents of a policy are cheering the fact that no one knows about it, there’s cause for concern. But with the rhetoric so heated, it’s not always clear what, exactly, the concern is here. So let’s break it down.

Those who criticize conservatives for talking about “death panels” say that end-of-life counseling is an important service that should be available to those who want it. So far so good. Elderly or terminally ill patients have very difficult decisions to make, decisions which might not always result in more treatment. It is only prudent that they would seek the advice of their doctors for such matters.

If that was the end of the story, those decrying talk of “death panels” might technically be right. But here’s where the legitimate concerns come in.

With passage of ObamaCare, government has become an even larger stakeholder in virtually all medical decisions. What you personally decide as a participant in Medicare impacts the government’s bottom line, and thus also the ability of politicians looking to bolster their fiscally irresponsible images to get reelected.

Government additionally has a lot more power than other stakeholders. It has a lot more than the doctors, who rely on the stream of Medicare payments to stay afloat, and certainly more than you, the patient. So as time goes on, whose interests do you think are going to be served?

The only way to prevent politicians from expanding the role of government in end-of-life counseling is to not give it a role in the first place. This is why it was so concerning when such provisions popped up in ObamaCare, a bill that expanded the government role in health care across the board.

From what I hear, the new regulations seem less concerning than the initial provision. Unlike what was attempted with ObamaCare, these regulations provide no prescriptions concerning the content of end-of-life discussion, but merely allow that they will be covered under Medicare. I’m thus tentatively willing to consider that they may not be of significant concern.

However, liberal critics ignore legitimate concerns when they dismiss discussion of “death panels” as nothing more than overblown political rhetoric. There are very real dangers from allowing the government both a financial incentive to deny medical care and the authority to make it happen. I can think of few easier targets for a government looking to save money than elderly patients weighing whether or not they should continue receiving expensive medical treatments to extend their lives just a little bit longer.