The "death panels" are quite real... though they aren't necessarily called that. They do make decisions in those systems regarding what they will and won't do based on a person's age, condition, etc.
In the USA we have them too, they are called insurance companies and HMOs. No matter what you call it (death panels vs health board), or who is doing it (insurance company vs government), it is rationing. Rationing is not an evil word, it is simply a description of reality.
When there is limited supply (of resource or money) the amount of the resource consumed (health care) is rationed. In a purely market based solution the rationing is accomplished by those with $$$ buying up the supply and leaving those without, well without. In a regulated (insurance or government) system, some panel will determine the rationing.
In the USA, we pay a lot more per subscriber for our insurance, so the insurance company will provide more services before cutting you off. However we do not distribute this evenly over the entire population, as those without insurance get poorer (although they still get emergency) service. Europe smears the service evenly among its citizens, but funds it at a lower level per subscriber so they have to ration it earlier.
In Europe, if you bought private insurance on top of the public health, you can get USA style health care for similar cost. Although due to the small number of people participating it can be hard to find private providers.
My grandfather died recently. He was 91 and had been in extremely poor health for 5 years. After a recent infection the doctors wanted to go to drastic measures to treat him. Why? He was miserable, wanted to die years ago. After the infection he was in much worse shape and the little quality of life he had was completely gone. They would have done exploratory surgery to find the source of some bleeding in his urine. Most likely he had a cancer of some sort. They would have wasted hundreds of thousands of dollars on a procedure that would have put him in much greater pain, and in his condition would probably have killed him anyway.
Thankfully grandpa's health directive was clear, and all his kids supported it, so the doctors were fine with putting him in hospice. However, they told us if one of his three children would have complained, they would have treated him with heroic efforts even despite his health care directive and the objection of the person assigned as power of attorney.
They said it happens frequently, they don't even agree with it, but they have to do it to protect themselves from wrongful death law suits. I don't have statistics to back this up, but my gut feeling tells me its this last 2 weeks of futile expensive health care that is going to make Medicare insolvent. And the reason it's expensive now when it didn't used to be, is simply that the surgery technology now exists to be used and it didn't before. 30 years ago, the only option for someone in my grandfather's situation was hospice.
Its an awful moral dilemma. Assume that 20% of those procedures turn out well. Well then it seems horrible to not try it on everyone in case they're one of that 20%. But if we simply can't afford it what do we do?
So, I say the good outcome rate for the procedure needs to be greater than 50% for Medicare to pay for it. Lower than that and you have to pay for it yourself. Assuming I'm right about the cause of Medicare insolvency, this probably would solve it.