Death Panelling Goes For Cheap
Congressman Earl Blumenauer (D-OR) writes in The New York Times about his intentions and the ramifications of a small piece of legislation he added into the health care package.
. . . I found it perverse that Medicare would pay for almost any medical procedure, yet not reimburse doctors for having a thoughtful conversation to prepare patients and families for the delicate, complex and emotionally demanding decisions surrounding the end of life. So when I was working on the health care bill, I included language directing Medicare to cover a voluntary discussion with a doctor once every five years about living wills, power of attorney and end-of-life treatment preferences.
Blumenauer writes that he spoke to several conservative Congressman and that during the mark-up session in the House Ways and Means Committee, “Nowhere was there a single proposal to change the end-of-life language, nor a word spoken in opposition. Not a single word.” Blumenauer writes about how lobbyist Betsy McCaughey and Congresswoman Viriginia Crazy-Like-A-Fox as well as Sarah Palin’s infamous Facebook rant all stoked up the flames of ignorance and falsehoods about what the legislation was to provide — and it wasn’t death panels.
But it all falls on to the doorstep of the media, who “after aiding and abetting falsehood, were unable to perform their traditional role of reporting the facts”, writes Blumenauer.
Tags: Health Care Reform
Thanks for that, nemski. That is Sunday’s required reading. Such a rationed, reasonable response. The article could also have been titled “The Evolution of Stupid.”
If our system depends on a reasonably good “4th estate” media watchdog – then our democracy needs to start considering its “end-of-life treatment preferences.”
I support payments for this counselling, however I just took a step back and thought: How effed up are physicians now that they won’t even talk to their patients about their own deaths unless they get a check.
Anon — According to my father in law, a geriatric family doc, the docs always do, and even this small payment won’t reimburse them for the amount of hours they put in on this…but it is an acknowledgment of the job and an awareness of the effort.
It isn’t one conversation. Ever.
My experience is that doctors answer to a host of masters, these days. In a group practice, everyone’s time must be accounted for, and closely. So having a billable code for these conversations means that people aren’t looking at Doctor A’s throughput averages and pushing him/her to “tighten up the schedule”.
And I’m sure that doctor’s cannot lie when reporting billable hours, maybe something called fraud . . . medical fraud.
There’s a decent amount of time given to this counseling — in my experience way more time than a typical office visit would take.
Right on cass..and as unpalatable as it may seem to some, it needs to be done. Look how people were “offended” when pre-burial counseling/arrangements started up? I can’t count the number people now I’ve met who were glad the parents “laid it out” for funeral arrangements. Believe me these doctors’ conversations NEED to happen, because I’ve seen more than my share of paths derailed in end of life decisions because of one sibling/child showing up from out of town, last minute, hurried, and demanding everything be done…when those who have been there making the decisions, seeing the demise of the loved one have come to an agreement—I have yet to see a doctor continue w/ the on site think…and immediately retract and pursue heroic, rescusitative efforts because of that lone wish of some next-of-kin. And that dear readers is how 80% of your health care dollars are used in your last 30 days of life. If attorneys can charge to draw up wills, and undertakers for funeral planning, why not the dang discussion be reimbursed for which way and how long you want your last days be played out? The doctor is somewhat the conductor of this opera gang. FTR…my mother wants no heroics…my father wants every piece of equipment, and technology, up to and including research and trial for anything out there to keep him going. Guess who gets to oversee all this?