Someone in the society has to deal with the reality that there are finite resources and we're Making trade-offs, and be explicit about that. When the car companies were found to have a memo that actually said, 'This safety feature costs X and saved Y lives,' the very existence of that memo was considered damning. Or when you made it reimbursable for a doctor to ask, 'Do you want heroic care at the end-of-life,' that was a death panel. No, it wasn't a death panel! It was asking somebody to make a decision.