"End of life counseling" has been framed. No longer is it a neutral phrase that refers to a government-fostered enhancement of the doctor-patient dialog. It is now apparently so polarizing and so toxic now that the Senate Finance Committee is willing to strike a provision from its bill that would add a counseling benefit to Medicare. The Wall Street Journal reports that the measure will be excluded from the committee's mark because it has become controversial. As the Journal notes, "dumping the provision would thwart a broad effort in recent years by doctors and hospitals to encourage patients to plan for end-of-life care." That's as close as a newspaper can come to saying: what a dumb thing they're doing! The issue _is_ touchy -- but in the context of the health care debate, it has become, in just a few days, synonymous with an attack against the entire concept of health reform: that Democrats want to ration care. A question, though, for those Democrats and liberals who'll be angry about this: the response to Palin's remarks about "death panels" as well as to Sen. Chuck Grassley's repetition of the idea was swift and fairly unequivocal: it's not as if the pro-reform side didn't quickly rebut the issue with better facts. My sense is that fear-based emotional appeals set in more quickly than reason-based emotional appeals -- always have.