Defense of Payments for "End-of-Life"
Counseling Falls Flat
Part Two of ThreeBy Dave
Andrusko
The Christmas day story in the New
York Times continues to send shockwaves.
Unbeknownst
to no one except a select group of supporters, tucked in a 692-page Medicare
fee schedule was language to pay for "end-of-life" counseling.
When the Times' Robert Pear wrote
about the Medicare regulation, defenders of the Obama Administration
immediately went into overdrive to protest the regulation's innocent
intention.
For example, a story in yesterday's
POLITICO insists the counseling is "voluntary" and that there is (at this
point) no "script," altogether missing the objections of organizations such
as NRLC.
For starters, the Obama Administration
is trying to accomplish by administrative measures what it couldn't
accomplish (because it was taken out) in the final ObamaCare law. There is a
reason such "counseling" was omitted: the public was properly enraged.
For another, the final statutory
version of ObamaCare authorizes Medicare coverage of a yearly "wellness
visit." But under the new regulation, which had gone undetected, as of
January 1, the annual visit will now cover "voluntary advance care planning"
to discuss end-of-life treatment which critics worry may include
authorization to withhold lifesaving medical treatment, food and fluids.
A major reason critics were alarmed at
the original House proposal (Section 1233) is that they feared it meant that
efforts would be made to cut down on health care costs by convincing elderly
people to forego expensive treatment.
The irony is that the conclusion of
the POLITICO story eagerly talks about the cost-containment potential of the
new change. After including assurances that the Medicare regulation "is not
about rationing care or saving money, it's about making sure patients
understand what options are available before there is a health care crisis,"
the reader is immediately told "this benefit might save money for the
Medicare program over time" by an unidentified Senate aide.
"'If people take advantage of it, it
could save billions for taxpayers,' the aide said, by respecting the wishes
of people who realize that Medicare coverage is available for end-of-life
counseling, as well as for hospice and palliative care."
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Part Three
Part One |