The "fear" of government sponsored health care

Recently on Slate.com, "Scaring Grandma" relayed the speed bump in the Obama health care plan--reducing Medicare expenses, which some interpret to mean denying end of life care.

Here's an excerpt:

Many senior citizens are concerned that health care reform would mean cuts to Medicare. That much was clear at a town-hall meeting hosted Tuesday by the American Association of Retired Persons at which Obama fielded questions from seniors who don't want to give up their benefits.

But one question stood out. It addressed what the host from the AARP called the "infamous" Page 425 of the House health care bill. (Read the bill here.) "I have been told there is a clause in there that everyone that's Medicare age will be visited and told to decide how they wish to die," said Mary from North Carolina. "This bothers me greatly, and I'd like for you to promise me that this is not in this bill." The host elaborated: "As I read the bill, it's saying that Medicare will, for the first time, cover consultation about end-of-life care, and that they will not pay for such a consultation more than once every five years. This is being read as saying every five years you'll be told how you can die."

In a more balanced description of the options before Congress, the National Academy of Elder Law Attorneys reports:

The Secretary of HHS has sent a comprehensive report to Congress entitled “Advance Directives and Advance Care Planning.” The report, requested by Congress in 2006, focuses on (1) the best ways to promote the use of advance directives and advance care planning among competent adults as a way to specify their wishes about end-of-life care; and (2) addressing the needs of persons with disabilities with respect to advance directives. You can link to the report at: http://aspe.hhs.gov/daltcp/reports/2008/ADCongRpt.htm. It includes an excellent literature review on every aspect of advance care planning, analyses of key ethical and legal issues, and a discussion of opportunities to enhance the effectiveness of advance care planning and advance directives. The report is particularly timely as health care reform is in the public policy forefront, and several bills are pending on the Hill regarding a dvance care planning and improving care near the end of life.

In addition to the full report, a background report is available at ttp://aspe.hhs.gov/daltcp/reports/2007/adacplpi.htm.

Happy reading!