Last summer, when the health care debate was in full swing and members of Congress were being hounded at their town hall meetings, it was often heard that the bill being debated would provide for “death panels” in which groups of experts might decide if someone should be allowed to die.
The panels were actually consultations with doctors on end of life wishes, to be paid for by Medicare. I expressed concern at the time that in a bill designed to lower health care costs would include a feature like this. Congress was saying, let’s save money (and end of life costs are extraordinary), and let’s have patients talk to doctors about their end of life wishes. It seemed–at least gave the impression–that the bill’s writers hoped those consultations would save money by encouraging people not to pursue medical care that might lengthen life.
However, such consultations were not death panels, and now the Congressman who originally proposed them is about to do so again. This time, I’m a fan. CNBC reports:
When Rep. Earl Blumenauer pitched the idea of reimbursing doctors for end-of-life counseling last year to Congress, it met its demise after Sarah Palin claimed it would amount to setting up “death panels” that decided whether someone was worthy of getting health care.
Blumenauer said Wednesday he plans to resuscitate the legislation. He said the substance will be essentially the same, but the bill will be “tailored, renamed and focused” to make it less of a political target.
At a news conference, the Oregon Democrat reflected on the furor that played out over his idea last year: “How did something so simple and direct get mixed up with death panels and weirdness?”
“We think we have a piece of legislation about which there can be no legitimate dispute,” he said.
Blumenauer wants to allow Medicare to pay doctors for voluntary counseling sessions that address end-of-life issues. The conversations between doctor and patient would include living wills, making a close relative or a trusted friend your health care proxy, learning about hospice as an option for the terminally ill, and information about pain medications for people suffering chronic discomfort.
The sessions would be covered every five years, more frequently if someone is gravely ill.
These are all good things. Mostly, it is a good thing to encourage people to talk about their end of life wishes. The fact is that while 80 percent of people say they want to die at home with family members nearby, instead 80 percent of people die in medical institutions. This mismatch isn’t entirely due to people changing their minds after being surveyed. People are not dying the way they wish to. Talking with a doctor about it will help fix this.