Medicare Proposes Paying for Discussions on End-of-Life Care

[DonViejo]

Last edited Wed Jul 8, 2015, 06:07 PM - Edit history (1)

Source: New York Times

After years of debate about whether the government should encourage end-of-life planning – an idea that Sarah Palin claimed would lead to “death panels” cutting off care to the sick – Medicare, the federal program that insures 55 million older and disabled Americans, is now proposing to reimburse doctors for having conversations with patients about whether and how they would want to be kept alive if they become too sick to speak for themselves.

This new policy, announced Wednesday, comes at a time when patients, families and health providers are placing greater emphasis on allowing people to choose the way they die – whether that means trying every possible medical option to stay alive or discontinuing life support for those who do not want to be sustained by ventilators and feeding tubes.

Since Medicare often sets the standard for private insurers as well, the new policy will likely prompt many more doctors to engage patients in such discussions about their preferences. Some private health insurance companies have recently begun covering advance care planning conversations, and more are likely to adopt reimbursement now.

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Read more: http://www.nytimes.com/2015/07/09/health/medicare-proposes-paying-doctors-for-end-of-life-counseling.html?

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Medicare Will Cover End-Of-Life Care, Resurrecting 'Death Panel' Outrage

WASHINGTON (AP) — Medicare says it plans to pay doctors to counsel patients about end-of-life care.

That's a turnabout for the idea that sparked accusations of "death panels" and fanned a political furor over President Barack Obama's health care law six years ago.

The policy change, effective Jan. 1, was part of a massive regulation issued Wednesday.

It suggests that what many doctors view as a common-sense option is no longer seen by the Obama administration as politically toxic.

Counseling would be entirely voluntary for patients.

http://talkingpointsmemo.com/news/medicare-end-of-life-death-panels-obama

[pinto]

1. +1. Good proposal. It's a discussion MD and patient should have, imo.

I'm all for Medicare adding it to reimbursement guidelines. Medicare certified hospice programs already include it as an inherent part of their programs.

[Brickbat]

2. This conversation will continue to get louder as boomers age.

We're just starting to see the very beginning of it. They have dealt or are dealing with their near-death parents and want things to be better for themselves.

[calimary]

10. Yep. GREAT point.

I'm all in. Watched both my parents and my mother-in-law go down slow and hard. A really slow and painful decline. I wouldn't wish it on ANYBODY. We knew it was over for my mom during the last two months of her life, sick, miserable, and most of the time in the hospital, a complete invalid, trussed up with wires and tubes and IV drips of all kinds. We knew it when she started stating "this isn't living. This isn't living."

That should be a choice. It's a most personal and intimate thing - and at perhaps THE ultimate serious moment in one's life. No government official or religious butt-in-ski need weigh in. It's none of their business.

[Brickbat]

11. Part of it is our backwards medical system, which is dedicated to extending life at all costs

without considering the wishes of the patient for a quality of life. Part of it is our culture's discomfort with talking about death. You're right -- it really is the most serious moment in a person's life.

My parents and my in-laws have both told me/my partner that they have taken steps to ensure that what their parents went/are going through won't happen to them. "When the time comes, you won't have to worry about it." It's a great gift to me that they are privileged enough to do so -- everyone should be able to make the same choices.

We give our pets a better death -- one last best day, and then a long sleep. Why can't the people we love elect to do the same?

I am so sorry you and your mom went through such a hard time. I've had relatives say, "When i get like that, take me out to the back 40 and..." Unfortunately, we have no process for taking people out to the back 40, figuratively or otherwise.

[calimary]

12. Thanks, Brickbat.

Sigh - it was just one of those things. Not a terribly happy time and couldn't have been more miserable for her. Actually, for all three of them. One VERY small "blessing" if you will - my sweet mother-in-law began to suffer the effects of Alzheimer's in addition to everything else that ailed her so seriously. It was sad. Toward the end, there was nobody in there anymore.

All three of 'em - I do NOT want to linger like that.

[Ruby the Liberal]

3. Excellent news

Too often, we put people through pure hell on earth trying to keep them alive when their body is ready to go. Death is a natural part of life -- its time Medicare et al accept that and offer ALL humane options.

[jtuck004]

4. We should start discussions about end of life in grade school. Care and other areas. n/t

[TexasBushwhacker]

5. It's a start

Considering that one will be on Medicare until they die, I think it's appropriate that Living Wills and Medical Power of Attorney paperwork be included in the packet that's sent out to new enrollees.

I knew my mother's wishes because she died slowly and we discussed it. But my father had a massive stroke. Apparently he had not discussed his wishes with his wife and she had great difficulty letting him die naturally. She hung on to false hope and allowed him to be kept alive with a feeding tube and ventilator for several months. He eventually died of a bedsore on his tailbone that was 7" in diameter. His care during those 6 months cost Medicate hundreds of thousands of dollars.

30% of Medicare dollars are spent on caring for people in their last year of life. I'm not talking about death panels. I'm talking about people making their own healthcare decisions while they're healthy and lucid.

[restorefreedom]

6. always good to know options and what people want for themselves

this is what worried me about repubs keeping all insurance private. for the sake of saving and pocketing more $, private insurers could have bullied people out of care options if they wanted them.

interesting that they were the ones yapping about death panels. their "plan" was the real danger.

[awoke_in_2003]

7. We need to bring the option...

to terminate one's life into the discussion, too. I know if I am diagnosed with Alzheimer's I am taking matters into my own hands. We should be allowed to make that choice without it affecting life insurance payouts.

[brer cat]

8. I wish more families

would join in these conversations together. Often, it is not the patient's wishes but the family members' that rule. A time of great stress and grief for the family is not necessarily a good time to be deciding.

[passiveporcupine]

9. Every time I've had surgery in the last 20 years

The hospital has provided me with a packet of information about how I want things to be handled if something goes wrong. They want your signature on that paperwork on file, so they know what to do. I think it's very important and I have no problem with your doctor getting involved in a discussion, if you need that too.

[Elmer S. E. Dump]

13. DEATH PANELS! SARAH PALIN WAS Right ALL ALONG!!!

Just in case....