Tuesday, August 11, 2009

Health Care Reform: End-of-Life Planning

Much is being written (and misrepresented) about Section 1233 of the Healthcare Reform bill currently in the House bill. This is the section of the bill that modifies the Medicare regulation and provides for medical payments for consultations with your personal doctor related to end-of-life care (living will preparation). Radicals on the far right are characterizing this section of the bill as legislating the creation of death warrants for seniors, thus denyingcare for seniors. That mischaracterization of this section is anything but the truth and is merely a scare tactic to mobilize opposition to the bill.

Over the past few days, I read two quality articles on this subject in the Washington post. The first was an op-Ed by Charles Lane titled, Undue Influence. The second was an article detailing readers responses to the Undue Influence article, titled Views on the Goverment's Role in End-of-Life Planning.

I would encourage you to read both articles. The "Undue Influence" article is written from a skeptic's point of view, questioning whether a doctor might place senior citizens in situations where they feel pressured to sign end-of-life directives that they would not otherwise sign, and questions whether the motivation for this section is monetary, or to really ensure end-of-life wishes of the patient. The "Views" article contains a number of email responses from WP readers who responded to the Undue Influence article with "thoughtful and often eloquent comments." The last "Views" response, from Sara Billings who was a daughter of an ailing father and who is also a healthcare professional, is well worth reading. It accentuates that gray area between feelings and finances, guilt and grief that plays into the hands of those trying to use it to incite fear and enlist people to work against the bill.

Section 1233 of the Healthcare bill does nothing to "limit" healthcare for seniors. If anything, it provides them the opportunity to have an extended consultation, paid for by Medicare, with their personal physicians (and with family members present, if so desired) regarding all types of end-of-life procedures, with discussions of both pros and cons of all types of treatment. It actually would help people (and their relatives) make informed choices. As it stands today, realtives are left to interpret on their own what their relative might have wanted and most of all, what the person's lawyer meant by "extraordinary measures" in their loved one's living will (or DNR—do not rescusitate order) after circumstances have turned awry.




Related Articles —
The Death Panels are Real [Huffington Post]
The Real Death Panels: Insurers Deny 22% of Claims [Daily Kos]

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