End-of-life counseling part of new Medicare policy

Posted on: December 28th, 2010 by The American Independent 1 Comment

The New York Times reported over the weekend that a provision of health care reform legislation that was abandoned after it became the focus of conservative outrage is making a return, this time as part of a new policy outlined in a Medicare regulation.

Voluntary counseling on end-of-life decisions was attacked by conservative pundits and politicians throughout the debate over health care reform, eventually labeled as “death panels.” The service would require Medicare to pay for end-of-life counseling sessions for anyone who requests them. The false claim that the provision would give government the power to decide whether seniors and the disabled were worthy of care became so prevalent in some circles that the Pulitzer-Prize winning PolitiFact website labeled it 2009′s “Lie of the Year.”

The claim began on the Facebook page of former Alaska Gov. Sarah Palin, but it was quickly picked up by other GOP dignitaries, including U.S. Sen. Chuck Grassley (R-Iowa). During a 2009 town hall forum in Winterset, Grassley told the crowd they “have every right to fear [the end-of-life provisions]. You shouldn’t have counseling at the end of life; you ought to have counseling 20 years before you’re going to die. You ought to plan these things out. And I don’t have any problem with things like living wills, but they ought to be done within the family. We should not have a government program that determines you’re going to pull the plug on grandma.”

Later in the day, Grassley repeated the claim, saying the provisions lead people to believe “that someone is going to decide grandma’s lived too long.

But experts say that type of rhetoric is false.

From The New York Times:

In a recent study of 3,700 people near the end of life, Dr. Maria J. Silveira of the University of Michigan found that many had “treatable, life-threatening conditions” but lacked decision-making capacity in their final days. With the new Medicare coverage, doctors can learn a patient’s wishes before a crisis occurs.

For example, Dr. Silveira said, she might ask a person with heart disease, “If you have another heart attack and your heart stops beating, would you want us to try to restart it?” A patient dying of emphysema might be asked, “Do you want to go on a breathing machine for the rest of your life?” And, she said, a patient with incurable cancer might be asked, “When the time comes, do you want us to use technology to try and delay your death?”

Under the new rule, Medicare will cover visits with doctors to discuss how to prepare an advance directive, stating how aggressively they wish to be treated if they are so sick that they cannot make health care decisions for themselves.

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