July 21, 2010

By Jennifer Popik, JD, Robert Powell Center for Medical Ethics

Jennifer Popik, JD

On March 23, 2010, President Obama signed into law the pro-abortion, pro-rationing health care restructuring plan, passed by the slimmest of margins. Prior to passage, while members of Congress visited their home districts over the 2009 summer recess, outrage erupted over the so-called "death panels."

What sparked the outrage was a section of the House bill, developed by Rep. Earl Blumenauer (D-Or.) along with Compassion & Choices, the nation's leading assisted suicide advocacy group. Section 1233 of the House-passed bill provided for Medicare reimbursements at least every five years for voluntary patient-physician end-of-life counseling sessions.

While that provision was passed by the House of Representatives as part of their health care reform bill, it was not included in the final version which became law. Very recently, Rep. Blumenauer announced that he will be reviving the much reviled provisions in a stand-alone bill.

Although the measure has some bi-partisan support, it is unlikely that it will be acted on this session. This does, however, present a good opportunity to examine what sort of provisions related to advance care planning did end up in the final version of Obamacare.

Obamacare advocates will tell you that the new law merely means that "patients will be given the information they need to make good decisions." But a deeper look uncovers an even more onerous scheme aimed at persuading Americans to reject costly yet life-saving care.

Under the new law, patients will be pushed and cajoled to reject life-saving treatment in order to reduce costs. Under the "Shared Decisionmaking" program, the federal government will contract with private entities to produce "patient decision-making aids" and doctors and other health care providers will be brought to regional centers to be trained in their use.

These patient aids will be pushed into every aspect of our lives--distributed by health care providers and even insurers. But what sort of "decision-making aids" are likely to be produced by these contracted entities?"

If you go to the website of the Foundation for Informed Medical Decision Making, you immediately come across a little box titled "Did You Know?" And in that box flash statements like these:

"About 25% of Medicare dollars are spent on people in their last 60 days of life." "Whether or not they receive active treatment, most men diagnosed with early stage prostate cancer will die of something else." "Back patients in Idaho Falls, Idaho are 20 times more likely to have lumbar fusion surgery than those in Bangor, Maine, with no clear difference in . . . quality of life." "For at least 70% of people who have heart bypass surgery, the survival rate is no better than if they had chosen to take medication alone." "More care does not equal better outcomes." "In many people with stable heart disease, medications are just as good as stents or bypass surgery." See the website at http://www.informedmedicaldecisions.org/

Do you notice a pattern? Clearly, this is a group that wants to discourage patients from choosing treatment that may be extensive or costly.

What about "Healthwise"? The home page of its website proclaims "avoid unnecessary care with Healthwise consumer health information," and its "Mission Statement" says "We help people ... do as much for themselves as they can [and] Say 'no' to the care that is not right for them." See http://www.healthwise.org/a_mission.aspx

Under the guise of giving accurate and unbiased information to guide their informed consent, these groups develop material whose clear bias is to push and persuade patients to reject medical treatment. So while Congressman Blumenauer's bill mirrors the language which sparked outrage across America, an even more dangerous threat was concealed in the new health care law.

Part Two