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A Quiet End to the ‘Death Panels’ Debate

Posted on 11/24/2015

NY Times — It seemed like a logical idea, the congressman told me, and not a particularly radical one.

American health care tends to encourage doctors to make money by ordering more tests and procedures rather than by having conversations with patients. But when those patients face decisions about what they want to happen, and not happen, as they near death, they need to talk over their options, not receive an additional M.R.I.

So in 2009, Representative Earl Blumenauer, then a seven-term Democrat from Oregon, introduced a provision into what would become the Affordable Care Act requiring that Medicare cover voluntary discussions with a physician about advance directives and end-of-life treatment preferences.

Geriatricians, palliative care doctors and hospice staffers all vividly remember what happened next: It was the Dec. 7, 1941, of advance-care planning.

Conservatives blasted the idea as the embodiment of evil, the precursor to government-sponsored euthanasia. Sarah Palin denounced the creation of “death panels.”

None of that was remotely true, but the measure disappeared from the health care act nonetheless.

Medicare officials later tried to incorporate advance-care consultations into a package of regulations, then backed off again. “It was the height of the frenzy, and the administration got cold feet and yanked it,” Mr. Blumenauer said afterward.

Last month, however, this six-year struggle came to a quiet resolution. With hardly a ripple of dissent, Medicare authorized payment for end-of-life discussions.

Now health care professionals can punch in a code to bill Medicare for sitting down with patients to discuss end-of-life decisions. They’ll get paid $86 for the first half-hour’s conversation in an office (in a hospital, it’s $80), and $75 for an additional 30 minutes. If you need to reopen the subject in a few months, or a few years, Medicare will pay again.

Read the full article from the NY Times.