The term “death panels” has been recklessly tossed around in the current healthcare debates. It has three entirely different meanings that some politicians have used to their advantage to create confusion, particularly among senior citizens.

Sarah Palin created a new meaning for the term when she described the panels as being persons selected by the government to decide which of the elderly would be selected to get medical treatment allowing them to continue to live out their lives and which of the elderly–because of their critical condition, the experimental nature of the treatment or its expensive cost–would be denied treatment and allowed to die. Republican Sen. Charles Grassley of Iowa reinforced this idea by similar comments. However, using the term in this sense is simply untrue.

What the healthcare bill actually talked about was providing counseling for seniors to allow them to choose not to use life support measures such as a feeding tube for nutrition and a mechanical ventilator for breathing when their condition is terminal and they do not wish to prolong their lives under those circumstances. Hospitals provide appropriate forms to their patients and attorneys like me serve as “death panels” every day, advise people about “living wills” (advance medical directives) that allow people to make choices about how they shall live out their lives. Note that with these death panels the people voluntarily make their own choices. The government does not make the decision for them.

The third type of death panel is the ones used by health insurance companies. This kind of death panel really kills people. People who are covered by health insurance and who have paid their premiums, perhaps for years, are suddenly denied coverage when struck with catastrophic illness (and catastrophic medical bills). The company reviews the claimant’s file. Perhaps the application for insurance leaves out a health condition that was not a problem at the time and has never been a problem, but it shows up in medical records. The company claims the applicant made a false statement and cancels the policy. Or, the company fails to renew the policy at the renewal date. Or, the company claims the treatment is experimental and not entitled to coverage. Review boards–selected and paid by the insurance company– make many of these decisions. These are the real death panels.

A recent example is Dawn Smith, who developed a brain tumor two years ago. CIGNA, a health insurance company, denied coverage for her treatment without explanation. After recently receiving more than 100,000 letters supporting Dawn from members of MoveOn, a political and social justice organization, CIGNA finally agreed to pay for the initial test to determine her treatment plan. This decision, however, does not mean CIGNA will approve the treatment.

The Obama healthcare bill never had and never will have the Sarah Palin death panel, It may or may not end up with the death panel (counseling for seniors) provision that we already have available. As currently proposed, will abolish the use of death panels (review boards) that insurance companies establish to deny needed benefits to their policyholders. And Dawn will be able to obtain full coverage for her treatment.