[imgbelt img=history0.jpg] The Washington Post reports this morning that the “death panel” myth began in La Crosse. La Crosse isn’t officially Yonder — Harrison County has a total population of over 125,000 and is considered a “metro” area — but the town on the western edge of Wisconsin isn’t Chicago either. Besides, it’s interesting to see how a helpful innovation in a smallish town has come to roil the nation. As Alec MacGillis tells us, the Gundersen Lutheran hospital in La Crosse (photo from 1902 above) “has taken the lead in seeking to have Medicare compensate physicians for advising patients on end-of-life planning.” This began when a local guy, Bud Hammes, returned with a doctorate in philosophy from Notre Dame to work at the hospital. He found a “troubling pattern” as family members struggled to make medical decisions for sick and dying relatives. The hospital urged people to plan ahead, while everyone was still healthy, and even offered doctors to help people write directives for how they wanted their care to proceed. People found the process helpful and over time 90 percent of the people in town have these legally binding directives. As a result patients at Gundersen spend 13.5 days on average in the hospital during their final two years of life. At UCLA’s hospital, it’s 31 days. At NYU, 54 days.Gundersen and a few other hospitals sought to change federal law so that these end of life planning sessions could be paid for by Medicare. Gundersen officials testified before Congress and the provision was placed in a health care reform bill. Then former Alaska Gov. Sarah Palin warned of “death panels” and the circus began. It all started, however, in La Crosse.