In TX a hospital's ethics panel can deny service. In most cases like this it's actually a way for the hospital to stop paying for pointless services that the patient can't afford. You can always pick up and move--sometimes just down the street--if you can afford it and the other place has a bed for you. If you're not sufficiently wealthy moving isn't an option.
My insurance company does the same kind of thing. I had a CAT scan and radiation therapy. The CAT scan needed prior approval. The radiation treatments required that a panel review my case and the proposed treatment. Both were approved, but a denial would have just meant I'd have to pay. Denial of service wasn't something the insurance company could wrangle. Unless you're not sufficiently wealthy to pay for the service.
The same's true in many countries with public health care. A panel or board decides what drugs and procedures are approved for payment. They may put age limits on who receives certain services or limits on how long to provide them. Experimental, less common, or unproven procedures won't be covered. In these countries there's a 2-tiered system, so the people denied coverage can go elsewhere and get the treatment if they can afford it. If you can't afford it, tough. In some places the doctors moonlight so the care on the side isn't too expensive, if the equipment's available. In other cases private care is a lot more expensive than it would be otherwise and doctors are either entirely private and serve the wealthy or entirely governmental employees and aren't allowed private practice.
In some countries with public health care the entire health care system is run by the state. Doctors aren't to provide private practice. The state doesn't want a two-tiered system. Any private care is illegal or nearly so and the bar is raised for private care: To afford private care you have to be able to leave the country or bribe bureaucrats to turn a blind eye.
The public health care law that the (R) said included "death panels" ... which kind of public health care system did it provide for?
Gotcha! It was a trick question. There wasn't a single public health care law. There were ideas, poorly defined and not very explicit. There were snippets of language floating about. Nobody bothered to define the terms in useful detail--and those who tried to found nobody wanted to accept their definitions--so no reasonable, logic- or fact-based conversation was possible. All we got was emoting and posturing, rhetorical flourishes and partisan sniping. We needed a consensus and a decision before hardly anybody was willing to define their terms.
The problem is that to really cut costs you have to do what Texas and the insurance companies do. To manage costs and keep the percent of GDP really low you need a single-payer, solely state-run system. For that, you need to have the state employ the doctors, either de jure or just de facto. You can't have lots of sliding scales. That's what most (R) dislike, and that's what (D) didn't want to say. Obama's tentative stab at a regulating panel that would do what insurance companies do triggered the "death panels" rhetoric; Britain and France do precisely this so it's not unthinkable. This would hurt a lot of people; who it would help wasn't the main point. But (D) focused on who'd be helped and how healthcare would be equalized and redistributed; many (D) were incensed that illegal immigrants weren't included. How, exactly, this would be made possible while saving gobs of money (or, since the baseline funding would actually increase by a fair amount, while keeping the cost within the newly redefined budgeted amounts or even come in under budget) was a question that wasn't very important. That it was under budget was a useful foil to parry (R) rhetoric. I got the impression that I was in a room where about 1/2 the people spoke only Thai and the other half spoke only Quechua and each group was talking primarily to itself; the Quechua speakers knew a few phrases of Thai and said them on occasion, sometimes accurately sometimes not; the same thing, cet. par., were true of the Thai speakers. (Then again, I often have that impression.)
It's no wonder Obama never offered a bill. It's also no wonder that it wasn't made available for everybody to read in plenty of time before being voted on. Or that it devolves most of the detail, for all of its 3000+ pages, to the executive. Or that "savings" included monies from all sorts of activites, from biofuels to student loans, while medical expenses that are sure to increase were kept separate from the HCRA.
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