If one truly thinks of it from a non-emotional perspective, death panels have been around for a long time. When an insurance company's committee decides that person X should not get medication Y because it is 'experimental' (even though there are very strong signs of its efficacy), that is essentially a death panel. They have existed for centuries (whether it is something as linear as battle-field triage, or more modern variants like the initial Tamiflu medications when there was not enough to go around, or the aforementioned Insurance co. committee deciding to not pay for treatment because it is too expensive ...I mean ....it is experimental). Now, people who have funds set aside can easily by-pass such issues (such as Steve Jobs, who had to go to Europe some time back to get some medical procedures/medication that he could not have acquired in the US, and when he came back he managed to get to the head of a waiting list in a different State ....by the way, I am not knocking him for that. If I was gravely ill, and all I needed was money to give me a fighting chance, you can be darn sure I would spend like it was water spilling forth from Niagara). What I am saying, and something I totally agree with you on, is as long as their is scarcity of a resource (any situation where there is an overhang of demand to supply, be it in the share market, in the housing market, alcohol during prohibition, drugs, organs, etc), tough choices have to be made (be it purchasing a block of shares at a valuation that you suspect may be too high, or people buying homes that would be easily underwater if fair valuation was calculated, or people deciding to open a Speakeasy and sell alcohol and hiring some 'tough chaps' with Tommies to protect the establishment, or drug mules deciding to risk it taking drugs to Saudi Arabia even when the punishment is beheading, or, finally, doctors/insurance companies/hospital boards deciding who gets the organ, and by that person getting it deciding who will die).
As you said, ultimately it comes down to a death panel decision, whether the panel is an insurance company committee, a hospital board, or a gaggle of nurses who think Joe Blow over there has a better chance than you and thus dedicating just that little extra of their time to him.