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Representative Earl Blumenauer (D-OR), who co-authored the provision in the House health care reform legislation mandating that Medicare would pay for periodic “end-of-life” counseling sessions between patients and doctors, releases a fact sheet called “Myth vs. Fact: Advance Planning Consultations in HR 3200” (see November 23, 2008, January 27, 2009, February 9, 2009, February 11, 2009, February 18, 2009, May 13, 2009, June 24, 2009, June 25, 2009, July 10, 2009, July 16, 2009, July 17, 2009, July 21, 2009, July 23, 2009, July 23, 2009, July 23, 2009, July 23-24, 2009, July 24, 2009, July 28, 2009, July 28, 2009, July 28, 2009, and July 31, 2009 - August 12, 2009). Blumenauer writes: “Few areas are more vital for honest discussion and careful consideration than end-of-life care for America’s seniors. Unfortunately, families often do not know their loved ones’ preferences for end-of-life care and are not confronted with these difficult decisions until an emergency arises. This leaves spouses, sons, daughters, and grandchildren unprepared; as a result families struggle to make decisions in the midst of turmoil. The House health care legislation includes a provision (Sec. 1233) that provides seniors with better care as they grapple with these hard questions. This provision extends Medicare coverage to cover the cost of patients voluntarily speaking with their doctors about their values and preferences regarding end-of-life care. These are deeply personal decisions that take thoughtful consideration, and it is only appropriate that doctors be compensated for their time.” He then corrects three “myths” surrounding the provision:
Myth: Patients will be forced to have this consultation once every five years. In reality, he writes, such advance planning consultations are entirely voluntary; the provision mandates that Medicare will pay for one such consultation every five years if the patient chooses. Under certain circumstances, Medicare will pay for more frequent consultations.
Myth: Patients will be forced to sign an advance care directive (or living will). Blumenauer writes that no such mandate exists in the legislation, or is being contemplated. Like the advance planning consultations, living wills are entirely voluntary.
Myth: Patients will have to see a health care professional chosen by the government. The government will not choose any health care professionals for anyone. If a patient chooses to have an advance planning consultation, it will be with a doctor of his or her choosing.
Blumenauer notes that the following organizations have endorsed his provision: the American Association of Retired Persons (AARP), the American Academy of Hospice and Palliative Medicine, the American College of Physicians, the American Hospice Foundation, the Center to Advance Palliative Care, Consumers Union, Gundersen Lutheran Health System, the Hospice and Palliative Nursing Association, Medicare Rights Center, the National Hospice and Palliative Care Organization, the National Palliative Care Research Center, Providence Health and Services, and the Supportive Care Coalition. (US House of Representatives 7/2009 ; Brown 7/28/2009)
Investigative journalists find that at least seven prominent Republicans who now denounce what they call “death panels” and claim that the Democrats’ health care legislation will lead to the untimely deaths of US senior citizens (see November 23, 2008, January 27, 2009, February 9, 2009, February 11, 2009, February 18, 2009, May 13, 2009, June 24, 2009, June 25, 2009, July 10, 2009, July 16, 2009, July 17, 2009, July 21, 2009, July 23, 2009, July 23, 2009, July 23, 2009, July 23-24, 2009, July 24, 2009, July 28, 2009, July 28, 2009, July 28, 2009, July 31, 2009 - August 12, 2009, August 6, 2009, August 7, 2009, August 10, 2009, August 10, 2009, Shortly Before August 10, 2009, August 11, 2009, August 11, 2009, August 12, 2009, August 12, 2009, August 12, 2009, and August 13, 2009) actually supported proposals similar to the legislation’s provision for government-funded “end-of-life counseling.”
Palin, Gingrich Supported 'Advance Directives' - In August 2008, Sarah Palin (R-AK), then the governor of Alaska, proclaimed “Healthcare Decisions Day.” She urged public health care facilities to provide more information about so-called “advance directives,” and said that seniors must be informed of all their options as the end of their lives draw near. The proclamation has recently been deleted from the Alaska governor’s Web site. Reporter Matt Taibbi notes that in late 2008 and early 2009, former House Speaker Newt Gingrich (R-GA) endorsed an aggressive “end of life” program from a Wisconsin health care provider, Gundersen Lutheran Health System, and wrote, “If Gundersen’s approach was used to care for the approximately 4.5 million Medicare beneficiaries who die every year, Medicare could save more than $33 billion a year.” Taibbi accuses Gingrich of “lying [about death panels] in order to scare a bunch of old people.” (Matt Taibbi 8/12/2009; Fang 8/13/2009)
Five Others Voted for End-of-Life Counseling - In 2003, five Republicans who now oppose the supposed “death panels” voted in favor of an almost-identical provision in that year’s Medicare reform legislation. Representatives John Boehner (R-OH), Thaddeus McCotter (R-MI), Johnny Isakson (R-GA), and John Mica (R-FL), and Senator Chuck Grassley (R-IA) all voted for the bill, which provided coverage for “counseling the beneficiary with respect to end-of-life issues and care options, and advising the beneficiary regarding advanced care planning.” Boehner, McCotter, and Mica have claimed that the current attempt at health care reform would lead to “government-encouraged euthanasia.” Isakson opposes the House legislation because it allows the “government to incentivize doctors by offering them money to conduct end-of-life counseling.” And Grassley told constituents that they are “right to fear” that government could “decide when to pull the plug on Grandma” (see August 12, 2009). (Sargent 8/14/2009)
Widespread Republican Support in 2003 - In all, 202 House Republicans and 42 Republican Senators voted for the Medicare bill. MSNBC host Rachel Maddow will say: “And there was not a peep about then-President Bush having a secret plan to kill old people. Bottom line? Either Republicans like Chuck Grassley and John Boehner and John Mica have totally changed their minds about whether living wills are really a secret plot to kill old people, or they voted for something just a few years ago that they actually thought was a secret plot to kill old people. Take your choice.” (MSNBC 8/17/2009)
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