But the term went viral. And now two groups that favor the legislation, including Obama's own grass-roots organizing network, are trying to turn the phrase to their benefit.
Search Google for "death panels," and often an ad headlined "Death Panel Myth" will appear. It directs users to a "Setting the Record Straight" page on the barackobama.com website that rebuts the claim that government panels would decide which patients could get lifesaving care.
Search for "euthanasia" or "section 1233" -- a provision of one health bill that is a focus of conservative attacks -- and an ad appears from the liberal group MoveOn.org. It links to a page that addresses "five healthcare reform lies" from opponents of Obama's plan.
Internet advertising has been growing for years. But the healthcare fight, which has erupted in confrontational town hall meetings over the summer, has generated more Internet ad buying than any public policy debate so far.
Interest groups of all sizes and perspectives have been buying ads linked to Internet search terms, often tweaking their "ad words" to keep up with the latest developments in fast-moving news cycles.
"Looking back at previous issue battles -- even thinking about the Iraq war, which was a passionate issue -- we didn't see anything close to the amount of online activity," said Peter Greenberger, Google's director of political advertising.
Obama's allies have bought ads that appear when users search for "Obamacare" and "socialized medicine," other terms commonly used by conservative critics of a healthcare overhaul. Even the blander "health care reform" can generate dozens of paid links to various advocacy groups.
At one point this week, as many as 97 organizations were buying ads linked to aspects of the debate. They included the seniors lobby AARP, the liberal group Health Care for America Now and conservative stalwarts such as the Club for Growth. The ads often solicit e-mail addresses and give readers the chance to sign up as volunteers or donate money to help promote, or oppose, legislation. Placement of the "sponsored links" depends on how much advertisers bid on a per-click basis, as well as Google's view of the ads' relevance.
"Even in the course of a year or the last 18 months, the way people are using the online medium has dramatically changed," Greenberger said.
Interest group strategists and officials from Google, which dominates the online ad market, say that many of the current tactics are inspired by the presidential campaigns last year of Obama and Sen. John McCain (R-Ariz.).
In an attempt to get ahead of the rumor mill, Obama's campaign bought ads linked to such search terms as "Obama Muslim." The ads directed viewers to a site debunking the rumors about Obama's faith.
McCain's camp was equally aggressive, quickly buying ads around "Joe the Plumber" when that phrase was repeated during a prime-time debate.
For Google, 2008 showed the revenue potential of political ads.
Obama's campaign paid the company about $9.4 million last year, almost all of it for advertising, according to data compiled by the nonpartisan Center for Responsive Politics. Numbers for McCain and the GOP are harder to compile, but people familiar with the spending put it at about $7 million.
Google is expanding the political sales team it created in 2007, aiming at future policy debates and elections as well as gubernatorial races this year in Virginia and New Jersey, where the candidates are spending heavily online.
Google began noticing the healthcare sizzle when certain phrases leaped to the top of its "hot trends" list, which shows the terms most rapidly moving up the list of the day's most popular Internet searches.
A peak in public interest occurred in mid-August, after Palin first warned of "Obama death panels." The phrases "section 1233" and "hr 3200," which were part of the "death panel" discussion, were surging to high spots on the trends list.
One big draw for advocacy groups is the relatively low cost of ads online. Some groups, such as the Club for Growth, have spent as little as a few thousand dollars on certain search terms. Others are buying ads not linked to search terms but instead placed on websites that are part of Google's advertising network. The ads can be targeted to websites in certain parts of the country -- such as those within the districts of undecided lawmakers -- or to sites with particular content, such as blogs or websites focusing on healthcare.
Still, it's not yet clear whether these paid messages are achieving the goals of moving public opinion or raising money or membership.
"We're still feeling our way through this," said David Keating, executive director of the Club for Growth, adding that the group has spent only about $4,000 so far on an "experimental" campaign.
"When we think we have the right formula, we'll ramp it up," he said.
The group is running an ad headlined "Stop Obama Socialism Now," which appears when a user searches for "Obamacare" and other terms. Through the ads, the group has signed up about 1,000 new members in recent weeks, though few if any have donated to the group.
At least one advertiser reports success, in traffic if not profit.
Indiana businessman Joel Nichols is selling bound copies of the health legislation for $125 on his site, buythebill.com. He spends about $40 a day to advertise next to certain Google search terms and $70 to have Kinko's print and bind each copy of the bill.
Nichols said he is getting 1,000 hits a day and is selling a copy of the bill every other day.
"It was kind of a whim," Nichols said. "But if I really wanted to make money, I might have better luck mowing yards."
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Snapshot of a search engine
Google's list of popular search terms has included a variety of healthcare overhaul phrases and buzzwords. By buying ads that appear on screen when someone uses those terms in an Internet search, activists and interest groups can reach people who are interested in the debate. On Aug. 11, these healthcare-related items were on Google's "hot trends" list, which includes the 100 search terms rising fastest in popularity. The terms' rankings are also given:
No. 4: section 1233 (a provision of one of the health bills)
No. 14: health care reform bill
No. 23: hr 3200 bill (the identification
number for one of the House bills)
No. 55: obama town hall meeting
No. 62: obama town hall meeting today
No. 83: obama health care plan explained
Other terms that have appeared on the list in recent weeks include:
* health care bill page 425
* health care reform bill text
* citizens for a public option
Source: Los Angeles Times