End of Life Plan Kicks up Controversy


“The only thing new here is a regulation allowing the discussions –authorized in 2003 by the prescription drug benefit — to happen in the context of the new annual wellness visit created by the Affordable Care Act.”— Statement from White House Spokesman Reid Cherlin.

New government rules encourage doctors to have patients on Medicare plan their “end of life” medical strategy.

The provision in President Obama’s national health-care law will compensate doctors for annual discussions with patients on what the Medicare recipients expect at the end and how to achieve their goals.

It’s all part of a long-standing push inside the health industry to get seniors to think strategically about the end. Most health costs come at the end of life, and convincing more seniors to pull their own plugs in advance would represent huge savings.

In order to get the $500 billion in slated Medicare cuts that are part of Obama’s health law, federal officials need to realize substantial end-of-life savings.

The Sunday New York Times reported that annual meetings to encourage patients to plot their final exits would now be covered by Medicare. Sensitive to allegations that the federal health law will encourage creeping euthanasia as government-paid doctors look for ways to save the government money, the administration hit back hard.

A spokesman pointed to language in the 2003 Bush-era expansion of Medicare that allowed for a “welcome to Medicare” visit with a doctor, which might include an end-of-life care discussion. The new policy, he said, just makes that discussion an annual event for seniors.

The message is that it may be creepy for the government to pay for people to talk about planning to die, but George W. Bush did it first.

This episode should provide some idea about how difficult it will be for the administration to realize the massive cuts to Medicare required under the new health law.

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