Pro-life power: Obama administration pulls plug on end-of-life counseling
On Sunday pro-aborts hotly disputed that the Obama administration had done anything wrong by reinserting payment for end-of-life counseling into Obamacare as a regulation when Congress, under pressure, had earlier axed it from the bill.
But less than 2 weeks after the New York Times revealed it was back, it’s gone again, also according to the NYT. Wrote the National Right to Life Committee in an email alert upon learning the news (bold highlights theirs):
But late last night, an abrupt reversal by the Obama administration came when they decided to drop this dangerous “end-of-life care” provision which would have been used to nudge or pressure older people to agree to less and less expensive treatments.
The sudden change shows that pro-life opposition can and will make a difference! It is clear that the Obama administration is nervous about bringing attention to the many rationing elements its health law. We must redouble our efforts to expose to all the rationing inherent in the ObamaCare.
Yes, Obamacare still contains rationing, as NRLC explains here and here. Only repeal will kill it.
Jill Stanek is a nurse turned speaker, columnist and blogger, a national figure in the effort to protect both preborn and postborn innocent human life.
Score another one for sarah Palin.
This is wrong. Are you aware of studies showing that much end-of-life care does not benefit the patient in terms of either longevity or quality of life? So many people have a “do everything you can” attitude toward health care, even when what can be done does no good whatsoever to the patient (and may just make their remaining time miserable). Why is it a bad thing for patients to be well informed about their options for end-of-life care — both the positive and the negative aspects of all the possible options? We argue for fully informed consent for women seeking abortions, but patients shouldn’t be fully informed of the risks and benefits of palliative care, hospice, and aggressive medical intervention at the end of life?
Jen R.
Is what you described in Obamacare?
But late last night, an abrupt reversal by the Obama administration came when they decided to drop this dangerous “end-of-life care” provision which would have been used to nudge or pressure older people to agree to less and less expensive treatments.
What was in the health care reform bill was a provision that doctors would be reimbursed for sessions in which they conferred with patients about their end-of-life care options. This link gives a good description of it:
http://www.healthinsurance.org/glossary/advance-care-planning-consultations/
If somebody’s determined to think of it as a “death panel” because it was in a Democratic bill and Democrats are evil and want to kill all our grandmothers, I know better than to think I’ll be able to stop them. (I’m not saying you’re like this, Carla; I don’t know you. But there are people like that out there.) But it’s just not supported by any reasonable reading of the facts.
“this dangerous “end-of-life care” provision which would have been used to nudge or pressure older people to agree to less and less expensive treatments”
That’s NRLC’s interpretation. It’s not true, except to the extent that “less and less expensive treatment” is often the better choice from a patient welfare standpoint, and thus more people would probably choose that if they were fully informed. It’s not true that just because a medical intervention can be done, that it should be done and will benefit the patient.
I should clarify that the “nudging and pressuring” isn’t true. That people would choose fewer interventions if they were more fully informed probably is.
I do agree that folks should have their wishes for medical intervention made clear and options spelled out for them. I agree with your first paragraph. But I do not want euthanasia to be part of that plan.
To be honest I haven’t read Obamacare for myself, I was just wondering if what you spelled out in your first paragraph is actually what is in there?
I read it at the time, but since it wasn’t in the version of the bill that passed, I’m having a little trouble finding it now. It was in no way a pro-euthanasia provision. That link to healthinsurance.org gives a pretty good summary of it.
Good end-of-life planning mostly involves doctors listening to patients, giving honest answers to their questions, and helping them figure out how to get what they want out of whatever time they might have left. For some patients, that’s going to be a full-on fight against death with whatever tools are available. For others, it’s going to be something more peaceful, with measures to keep them comfortable and able to enjoy their lives and families, and without aggressive measures that might cut into that. All the proposal does is say that if Medicare patients request this counseling from their doctors, Medicare will pay for it.
I should clarify that the “nudging and pressuring” isn’t true. That people would choose fewer interventions if they were more fully informed probably is.
Jen, good posts. And the problems with Medicare remain, and outside of silly political games, many members of Congress among Republicans as well as Democrats know that something has to be done and support such measures.
This whole debate will baffle me for years. I thought we didn’t want Terri Schiavo type situations where courts and other people had to figure out the intention of people? Guess not.
Uh, Jen – did you check out the links??
Being informed about decisions sounds like common sense. However the Obamacare legistlation provides money to BIASED organizations to develop materials to help with this. The problem is that the organizations likely to produce these materials are biased towards devaluing a life with any sort of disability or chronic disease. Why spend health dollars on someone who never be 100% healthy? Can you say slippery slope to euthenasia? And when you add in the cost factor that is rationing. In additionthe Obamacare legistlation prevents people from spending their own money on treatments (NRLC links in Jill’s article).
Let me repeat the flaw with this ”end of life counseling” is that it is based on placing a value on a life (A disability is a reason not to give care to a person because what’s the value of a life with hardship?).
Plus hospitals already provide information about living wills and such: no need for legistlation for this.
Last point: People survive amazing things but they won’t if they don’t get care. My mom was in ICU for 4 weeks in 2009 and all the doctors thought she was going to die. But she didn’t! With 3 months rehab in a nursing home, she got her strength back and went home. But you can be sure if Obamacare were the rule, she would have been denied the treatment that saved her because she has cancer.
I understand that we need to make costs part of the health care discussion but we need to find a way to put the CONSUMER in charge. And end of life counseling encouraging people to let themselves die if they need assistance to live is not the way to encourage our society to find a way to care for those in need.
“However the Obamacare legistlation provides money to BIASED organizations to develop materials to help with this.”
I didn’t see anything about this in any of the linked articles. Examples?
“Let me repeat the flaw with this ”end of life counseling” is that it is based on placing a value on a life ”
No, it’s not. It’s based on people getting care that will actually *help* them have the life they want, inasmuch as that’s possible.
Yeah Denise – could you post some of the verbiage from the actual bill (I don’t see anything on this in section 1233)
Coverage of certain physician’s services for certain terminally ill individuals would be authorized. Persons entitled to these services would be individuals who have not elected the hospice benefit and have not previously received these physician’s services. Covered services would be those furnished by a physician who is the medical director or employee of a hospice program. Services would include evaluating the individual’s need for pain and symptom management, counseling the individual with respect to end-of-life issues and care options, and advising the individual regarding advanced care planning. Payment for such services would equal the amount established for similar services under the physician fee schedule, excluding the practice expense component.
Really, what is so bad about advanced care planning?
What is so bad is when ‘advanced care planning’ turns into ‘put them in hospice and drug and em till they die’. You are a sick bunch.
“What is so bad is when ‘advanced care planning’ turns into ‘put them in hospice and drug and em till they die’. ”
That’s not what’s being discussed.
Who’s a sick bunch, and why?
Pro-life Arizona Governor Jan Brewer’s “Brewercare” has established death panel in Arizona. The Arizona death panel story has gone national.
http://www.cnn.com/2011/US/01/06/arizona.transplants/
What is so bad is when ‘advanced care planning’ turns into ‘put them in hospice and drug and em till they die’. You are a sick bunch.
Truthseeker, the “sickness,” if anything, is the need to pretend about this stuff, as you are doing.
By the way, what I quoted was from a bill signed by Bush Jr. when he was President, and among those voting for it were 204 Republican Congresspersons and 42 Republican Senators.
Everyone know of an elderly relative who has had a bit of a “martyr syndrome” and “doesn’t want to be a burden”. What is wrong with this is the monetary incentive for doctors to bring up “end of life discussions” every year. It won’t take much to wear down some patients to make decisions they might not otherwise.
Every five years, actually. And frankly, doctors will make a lot more money from patients who elect tons of aggressive interventions than from those who don’t.
(Hans): What is wrong with this is the monetary incentive for doctors to bring up “end of life discussions” every year.
Hans, I think Jen has a good point – the money paid for discussing things with the patients is quite small, per unit of time, and really is not an incentive for the doctors to do that versus other things.
I think most of us don’t want to be an undue burden, and that for ourselves we’d draw the line at some point. I’m not saying there is any perfect system, but if the patients have not figured out what they want to do about their own care, then I certainly think it’s better for them to hear the options versus not hearing them.