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Betsy McCaughey, the chairman of the Committee to Reduce Infection Deaths, a former Republican lieutenant governor of New York, and a conservative opponent of health care reform, says that under the Obama administration’s reform proposal, elderly Americans would be encouraged to die earlier to save money (see February 9, 2009 and July 23-24, 2009). On conservative radio host Fred Thompson’s show, she says, “Congress would make it mandatory—absolutely require—that every five years people in Medicare have a required counseling session that will tell them how to end their life sooner.” These sessions will help elderly patients learn how to “decline nutrition, how to decline being hydrated, how to go in to hospice care… all to do what’s in society’s best interest or in your family’s best interest and cut your life short.” (St. Petersburg Times 7/23/2009) “These are such sacred issues of life and death. Government should have nothing to do with it.” Thompson calls McCaughey’s claim the “dirty little secret” of the health care reform proposal. (St. Petersburg Times 7/23/2009; Brown 7/28/2009) In August, progressive MSNBC host Rachel Maddow will tell her listeners: “That is not true at all, not a word of it. Not mandatory, not require, not every five years, not counseling, not tell them, not how to, not end their life. None of the words in that claim are true except maybe the two ‘that’s’ and the word ‘in.’ It’s not true, but it is convenient, and so it survives. And it is in fact being promoted more than ever. It’s convenient for the interests [that oppose] health care reform to scare old people about reform.” (MSNBC 8/12/2009) The next day, McCaughey publishes an op-ed in the New York Post advancing the same arguments. “One troubling provision” of the bill, she writes, “compels seniors to submit to a counseling session every five years… about alternatives for end-of-life care.… [The] mandate invites abuse, and seniors could easily be pushed to refuse care.” (McCaughey 7/17/2009)
Availability of Discussions Mandated Since 1990 - The provision in question states that as part of an advanced care consultation, an individual and practitioner will have a consultation that includes “an explanation by the practitioner of the continuum of end-of-life services and supports available, including palliative care and hospice, and benefits for such services and supports that are available under this title.” Such explanations and consultations have been part of government-provided senior care since 1990; in 2003, the Bush administration issued guidelines for physicians’ discussion of end-of-life care with seniors.
Claims Contradicted - John Rother of the American Association of Retired Persons (AARP) counters with a statement: “This measure would not only help people make the best decisions for themselves but also better ensure that their wishes are followed. To suggest otherwise is a gross, and even cruel, distortion—especially for any family that has been forced to make the difficult decisions on care for loved ones approaching the end of their lives.” Jon Keyserling of the National Hospice and Palliative Care Organization adds: “I was surprised that any responsible legislative analyst would indicate this is a mandatory provision. That is just a misreading of the language and, certainly, of the intent.” McCaughey later responds to those statements by repeating her assertions, saying that doctors would “pressure” seniors to accept less costly services that would lead to quicker deaths. (St. Petersburg Times 7/23/2009; Brown 7/28/2009)
Debunked - McCaughey’s claims will soon be disproven (see July 23, 2009).
The St. Petersburg Times’s “PolitiFact” debunks the recent spate of claims by Betsy McCaughey (R-NY) that the Obama health care reform proposal would mandate ‘death counseling’ (see July 16, 2009) and encourage seniors to die sooner to save money (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 23, 2009, and July 23-24, 2009). Days later, the Annenberg Political FactCheck organization will come to the same conclusions.
'Advance Care Planning Consultation' - According to HR 3200, the latest version of the health care reform legislation, the relevant section is entitled “Advance Care Planning Consultation.” This details how Medicare would pay for voluntary end-of-life counseling sessions. According to the legislation: “such consultation shall include the following: An explanation by the practitioner of advance care planning, including key questions and considerations, important steps, and suggested people to talk to; an explanation by the practitioner of advance directives, including living wills and durable powers of attorney, and their uses; an explanation by the practitioner of the role and responsibilities of a health care proxy.” Medicare will pay for one such session every five years, and will pay for interim sessions if a Medicare recipient’s health worsens in between those five-year sessions. Jon Keyserling, general counsel and vice president of public policy for the National Hospice and Palliative Care Organization, which supports the provision, says the bill does not encourage seniors to end their lives, it just allows some important counseling for decisions that take time and consideration. “These are very serious conversations,” he says. “It needs to be an informative conversation from the medical side and it needs to be thought about carefully by the patient and their families.” According to Jim Dau of the American Association of Retired Persons (AARP), the legislation does not encourage patients to end their lives. Dau says McCaughey’s claims are “not just wrong, they are cruel.” He adds: “We want to make sure people are making the right decision. If some one wants to take every life-saving measure, that’s their call. Others will decide it’s not worth going through this trauma just for themselves and their families, and that’s their decision, too.” Keyserling says it is clear to him and his organization’s lawyers that such end-of-life counseling sessions are purely voluntary, like everything in Medicare. “The only thing mandatory is that Medicare will have to pay for the counseling,” says Dau. A press release from the AARP says that McCaughey’s characterization of the health care bill is “rife with gross—and even cruel—distortions.” (St. Petersburg Times 7/23/2009; Henig 7/29/2009)
'Scare Tactics' - The St. Petersburg Times concludes: “For our ruling on this one, there’s really no gray area here. McCaughey incorrectly states that the bill would require Medicare patients to have these counseling sessions and she is suggesting that the government is somehow trying to interfere with a very personal decision. And her claim that the sessions would ‘tell [seniors] how to end their life sooner’ is an outright distortion. Rather, the sessions are an option for elderly patients who want to learn more about living wills, health care proxies and other forms of end-of-life planning. McCaughey isn’t just wrong, she’s spreading a ridiculous falsehood.” (St. Petersburg Times 7/23/2009) The non-partisan FactCheck.org, an organization sponsored by the Annenberg Public Policy Center, will write: “In truth, that section of the bill would require Medicare to pay for voluntary counseling sessions helping seniors to plan for end-of-life medical care, including designating a health care proxy, choosing a hospice, and making decisions about life-sustaining treatment. It would not require doctors to counsel that their patients refuse medical intervention.” The organization will note that inflammatory “chain e-mails” are making the rounds making claims such as: “On Page 425 of Obama’s health care bill, the federal government will require EVERYONE who is on Social Security to undergo a counseling session every five years with the objective being that they will explain to them just how to end their own life earlier. Yes.… They are going to push SUICIDE to cut medicare spending!!!” FactCheck will respond: “In fact, [the part of the bill cited on p. 425] requires Medicare to cover counseling sessions for seniors who want to consider their end-of-life choices—including whether they want to refuse or, conversely, require certain types of care. The claim that the bill would ‘push suicide’ is a falsehood.” FactCheck will find that McCaughey “misrepresent[ed]” the bill in her claims, and she and other health care reform opponents are resorting to “scare tactics” to try to defeat the legislation. (Henig 7/29/2009)
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