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.