Years after Sarah Palin was mocked, and even received a Lie Of The Year award from Politifact, for suggesting that Obamacare contained ‘death panels’, the New York Times has reported that as early as next year Medicare will indeed reimburse doctors for end-of-life consultations.
Critics state that this will end up encouraging sick patients to reject costly treatments that would prolong their life. Of course, doctors will be on the government payroll, who will want to cut healthcare costs…if not for any reason than to line their pockets with more money, like we’ve seen at the VA.
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<!–nextpage–>And after the government ends up choosing who can go to medical school, which is surely on the government’s agenda, well…
End-of-life care represents around 22% of all of medical spending in the US. A former Obama adviser, Steve Rattner, has openly stated that we ‘need death panels’ to curb healthcare costs for everyone.
“We need death panels,” Rattner simply wrote. “ Well, maybe not death panels, exactly, but unless we start allocating health care resources more prudently — rationing, by its proper name — the exploding cost of Medicare will swamp the federal budget.”
DUNDEE, N.Y. — Five years after it exploded into a political conflagration over “death panels,” the issue of paying doctors to talk to patients about end-of-life care is making a comeback, and such sessions may be covered for the 50 million Americans on Medicare as early as next year.
Bypassing the political process, private insurers have begun reimbursing doctors for these “advance care planning” conversations as interest in them rises along with the number of aging Americans. People are living longer with illnesses, and many want more input into how they will spend their final days, including whether they want to die at home or in the hospital, and whether they want full-fledged life-sustaining treatment, just pain relief or something in between. Some states, including Colorado and Oregon, recently began covering the sessions for Medicaid patients.
But far more significant, Medicare may begin covering end-of-life discussions next year if it approves a recent request from the American Medical Association, the country’s largest association of physicians and medical students. One of the A.M.A.’s roles is to create billing codes for medical services, codes used by doctors, hospitals and insurers. It recently created codes for end-of-life conversations and submitted them to Medicare.
The Centers for Medicare and Medicaid Services, which runs Medicare, would not discuss whether it will agree to cover end-of-life discussions; its decision is expected this fall. But the agency often adopts A.M.A. recommendations, which are developed in meetings attended by its representatives. And the political environment is less toxic than it was when the “death panel” label was coined; although there are still opponents, there are more proponents, including Republican politicians.
If Medicare adopts the change, its decision will also set the standard for private insurers, encouraging many more doctors to engage in these conversations.
“We think it’s really important to incentivize this kind of care,” said Dr. Barbara Levy, chairwoman of the A.M.A. committee that submits reimbursement recommendations to Medicare. “The idea is to make sure patients and their families understand the consequences, the pros and cons and options so they can make the best decision for them.”
Now, some doctors conduct such conversations for free or shoehorn them into other medical visits. Dr. Joseph Hinterberger, a family physician here in Dundee, wants to avoid situations in which he has had to decide for incapacitated patients who had no family or stated preferences.
Recently, he spent an unreimbursed hour with Mary Pat Pennell, a retired community college dean, walking through advance directive forms. Ms. Pennell, 80, who sold her blueberry farm and lives with a roommate and four cats, quickly said she would not want to be resuscitated if her heart or lungs stopped. But she took longer to weigh options if she was breathing but otherwise unresponsive.
“I’d like to be as comfortable as I can possibly be,” she said at first. “I don’t want to choke, and I don’t want to throw up.”
With reimbursement, “I’d do one of these a day,” said Dr. Hinterberger, whose 3,000 patients in the Finger Lakes region range from college professors to Mennonite farmers who tie horse-and-buggies to his parking lot’s hitching post.
If Medicare covers end-of-life counseling, that could profoundly affect the American way of dying, experts said. But the impact would depend on how much doctors were paid, the allowed frequency of conversations, whether psychologists or other nonphysicians could conduct them, and whether the conversations must be in person or could include phone calls with long-distance family members. Paying for only one session and completion of advance directives would have limited value, experts said.
“This notion that somehow a single conversation and the completion of a document is really an important intervention to the outcome of care is, I think, a legal illusion,” said Dr. Diane E. Meier, director of the Center to Advance Palliative Care. “It has to be a series of recurring conversations over years.”
End-of-life planning remains controversial. After Sarah Palin’s “death panel” label killed efforts to include it in the Affordable Care Act in 2009, Medicareadded it to a 2010 regulation, allowing the federal program to cover “voluntary advance care planning” in annual wellness visits. But bowing to political pressure, the Obama administration had Medicare rescind that portion of the regulation. In doing so, Medicare wrote that it had not considered the viewpoints of members of Congress and others who opposed it.
Politically, the issue was dead. But private insurers, often encouraged by doctors, began taking steps.
Nope, didn’t miss it. I read it before it passed and after it passed. Those who were for it and never read it were just plain stupid idiots.
Time to stop them
This article is truly laughable it only gets scary when you scroll down and see the the comments. How idiotic can you be OMG people get a clue there are no death panels. There is however advanced directives in which you and your Dr discus your wishes for end of life care, you decide if you want extraordinary measures taken if your heart stops beating or if you just want comfort measures. People that believe Sarah Palins has anything relevant to say are as clueless as she is. The stupidity is amazing!
They plan to turn the disabled, including downs syndrome types over to the UN to care for them.
here is an idea ~ WHAT ABOUT GETTING RID OF OBAMA!
They are above the law and don’t use the same healthcare they force on everyone else.
There are some who think that suicide is a sin. What exactly does this mean in those terms? This is a pile of bunk. I guess if you want to choose that is your right but the government is sure taking a lot upon themselves even bringing this up. That is assisted suicide. What about Kavorkian? He went to jail for this very thing now it is okay? Hogwash.
Yep now they are asking questions they never did before. I resent it.
HAD to post this – this is our law IF we still lived under the “rule of law” : Under Section 8 USC 1324[a](1)(A)[iv][b](iii) any US citizen that knowingly assists an illegal alien, provides them with employment, food, water or shelter has committed a felony. City, county or State officials that declare their jurisdictions to be “Open Cities, Counties or States are subject to arrest; as are law enforcement agencies who chose not to enforce this law.
“Police officers who ignore officials who violate Section 8 USC 1324[a](1)(A)[iv][b](iii) are committing a Section 274 federal felony. Furthermore, according to Federal Immigration and National Act of 1952, if you live in a city, county or State that refuses to enforce the law for whatever reason, the officials making those rules are financially liable for any crime committed within their jurisdiction by an illegal alien.”
Du Tang,
Thank you for finding and explaining immigration laws to us. Few people actually know the law in this area.
We have always been a country of laws…but this administration freely, without apology, ignores immigration law, or any other they choose. Police Officers are actually encouraged or even ordered, to ignore section 8 in many places. So called “Sanctuary” cities, who deliberately ignore immigration laws, often do not even charge illegal aliens for crimes committed. And you can bet the officials of such cities aren’t held financially liable for crimes committed by illegal aliens, either. This has been going on even before Obama was president. So Obama doesn’t get all the blame for this, he’s just complicating the problem. I feel sorry for illegals who are escaping intolerable conditions at home. But it is their decision to come here. I just don’t understand why do we have laws that are neither amended nor enforced.?
disgusting