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January 6, 2011

Obama Admin. Reverses Course on End-of-Life Provision

On New Year’s Day, the government implemented new Medicare fee policies for physicians including a “voluntary end-of-life care” provision that would reimburse doctors for advising patients on end-of-life care. The following Tuesday, the Obama administration announced the revised regulations would remove the provision, effectively halting renewed controversy almost before it began.

The controversy threatened to re-ignite shortly after a memo from the office of Rep. Earl Blumenauer (D-Oregon) became public. (Blumenauer wrote the original end-of-life provision.) The memo celebrated the inclusion of the end-of-life provision in the Medicare regulations, which were released November 29 with little scrutiny. “The longer this goes unnoticed, the better our chances of keeping it,” according to the memo. The memo advised proponents to keep the inclusion “quiet” in order to avoid “the ‘death panel’ myth.”

A similar provision was dropped from the health care reform bill before it passed in 2009. At the time, detractors such as Republican congressmen John Boehner (R-Ohio) and Thaddeus McCotter (R-Mich.) protested funding end-of-life discussions between doctors and patients as the first step on a slippery slope toward “government-encouraged euthanasia.” Sarah Palin also stirred controversy over the end-of-life provision in the health care reform bill calling it a “death panel” mandate.

The National Right to Life Center indicated similar concerns with both versions of the provision. "The danger is that subsidized advance care planning will not just discover and implement patient treatment preferences but rather be used to nudge or pressure older people to agree to less treatment because that is less expensive," Burke Balch, director of NRLC's Robert Powell Center for Medical Ethics, said in a recent statement.

Opponents accused the Obama administration of achieving their goal to implement Medicare funding of end-of-life care through regulation rather than legislation. However, former New York lieutenant governor Betsy McCaughey, an outspoken critic of end-of-life provisions in health legislation proposed in the early 1990s as well as 2009, drew a distinction between the Medicare funding policy and health care legislation. Medicare should provide reimbursement for voluntary end-of-life counseling, she said. "But government should never prescribe what is discussed between doctor and patient, or pressure doctors financially to push their patients into living wills and advanced directives.”

The proposed new Medicare rules released last July did not include the end-of-life provision. However, the provision was included in the policies as released November 29. “We realize that this should have been included in the proposed rule, so more people could have commented on it specifically,” an administration official said Tuesday.

The New York Times speculated that White House administrators did not want a “distraction” to their defense of health care reform laws from the incoming Republican majority in the House.

The House is expected to vote on a proposed repeal of the health care reform bill next week. Rep. Eric Cantor (R-Va.) will introduce the repeal bill, which calls the 2009 health care reform bill a “job-killing health care law.” Republican leaders expect the repeal to pass the House, where they now hold the majority, but Democrats warn it will stall in the Senate.

Comments

The fact that liberals always obfuscate - yes, always - should give the public pause when supporting anything they promote. Sure, the end of life care provision sounds good, but like almost everything else liberals promote it results in something far more sinister. This way of wording bills is typical for marxist totalitarian regimes. 2012 cannot get here fast enough. Let's vote these bums out of office. (Interestingly enough, Sen. Claire McCaskill (D-MO) - the big BHO supporter for Obama Care - is now wavering in her support of it. And the citizens of MO should vote her out of office in 2012.)

Yes, I will accept advice/counseling approaching the "end of life" and will instruct my family to do likewise. This is not some crazy "death panel" scheme. When did counseling become more than just that....counseling? Let's remember one point the bible tells me/us; GOD IS IN CONTROL. Try and keep that in mind.

We do not need the government pushing any "counseling" on us regarding our health care. I have a living will and also directives but I chose that myself. These end of life issues should be what one feels about quality of life and not based on financial decisions. There should never be a "money figure" placed on the value of even one human being like we are some sort of cattle. And, the life of even one "old" person is not of any less value than a "young" one.
Dpctors and scientists have worked hard and long to extend our lives and develop medicines and therapies and equipment to accomplish this. We look forward to a continuation of this, so we don't need government intervention. We can use our own brains and hearts to help us decide our "end days".